Measles – Diagnostic – PCR
Conformément au Règlement de l’Ontario 671/92 de la Loi sur les services en français, les renseignements d’analyses de laboratoire liés à la présente page ne sont offerts qu’en anglais parce qu’ils sont de nature scientifique ou technique et destinés uniquement à l’usage des fournisseurs de soins de santé qualifiés et non aux membres du public.
This page provides diagnostic polymerase chain reaction (PCR) testing information for Measles at Public Health Ontario (PHO). For information regarding other testing options, including Cerebral Spinal Fluvid (CSF) for Subacute sclerosing panencephalitis (SSPE) refer to:
Updates:
- Effective July 29, 2024, testing is conducted only at Toronto site and available Monday to Saturday.
Content/Testing Indications
Measles PCR is a diagnostic test for the detection of viral RNA in clinical specimens collected from patients suspected of having Measles and is useful during the early phase of the disease following symptom onset.
For suspected cases of Measles - contact your local public health unit (PHU) prior to collecting specimens and notify PHO’s Laboratory Customer Service Centre prior to submitting STAT measles specimen(s) to our laboratory.
Acceptance/Rejection Criteria
Specimens received in incorrect containers or expired kits will be rejected.
Content/Specimen Requirements
Content/Test Requested | Content/Required Requisitions | Content/Specimen Type | Content/Minimum Volume Required | Content/Collection Kit |
Measles Virus Diagnosis |
Nasopharyngeal swab4 |
1 swab in transport media contained in kit |
Virus Respiratory Kit order#: 390082 |
|
Measles Virus Diagnosis |
Throat swab5 |
1 swab in transport media contained in kit |
Virus Culture Kit order#: 390081 |
|
Measles Virus Diagnosis |
Urine6 |
Minimum volume 10mL |
Sterile container |
Content/Submission and Collection Notes
Complete all fields of the requisition form, including:
- Test(s) requests and indications for testing
- Patient setting
- Clinical information (symptom and symptom onset), MMR/MMRV vaccination status and travel history (including date of travel/return).
- Indicate whether the local PHU was notified of the case.
For clinical specimens, label the specimen container(s) with the patient’s first and last name, date of collection, and one other unique identifier such as the patient’s date of birth or Health Card Number. For additional information see: Specimen Acceptance Criteria.
Failure to provide this information may result in rejection or testing delay.
For diagnosis of symptomatic patients, collect NP and/or throat, as well as urine specimens and blood for serology. See next section for the recommended timing of specimen collection.
Refer to the Nasopharyngeal Specimen Collection Instructions for collecting nasopharyngeal swab specimens.
Refer to the Throat Specimen Collection Instructions for collecting throat swab specimens.
Urine specimen collected in other media (i.e. CTNG specimen container) will be rejected for testing.
For submission of other specimen types please contact PHO’s laboratory customer service at 416-235-6556 or 1-877-604-4567.
Content/Timing of Specimen Collection
Nasopharyngeal swab or aspirate and/or a throat swab should be collected within 7 days of rash onset.
Urine should be collected within 14 days of rash onset and submitted in a sterile container.
In certain situations, such as when there is a high index of suspicion for measles (e.g. compatible illness in a returned traveler or contact of a laboratory confirmed case), it may be warranted to test beyond the above time periods when specimens could not be collected earlier in the illness. This can be discussed with PHO’s laboratory on a case by case basis.
Content/Storage and Transport
Place specimen in biohazard bag and seal. Specimens should be stored at 2-8°C following collection and shipped to PHO’s laboratory on ice packs.
All clinical specimens must be shipped in accordance to the Transportation of Dangerous Good Act.
Content/Test Frequency and Turnaround Time
Test |
Turnaround Time |
Test Location |
Frequency |
Sample receipt cut-offs* |
---|---|---|---|---|
Measles PCR |
Up to 3 business days from receipt at PHO Laboratory |
Toronto |
Monday to Saturday |
11AM |
Measles Vaccine Genotype PCR |
Up to 3 business days after the confirmation of Measles PCR positive |
Toronto |
Monday to Saturday |
N/A |
Measles full Genotype (NML) |
Up to 21 days from the receipt at NML |
National Microbiology Laboratories |
N/A |
N/A |
*Samples must arrive at PHO’s laboratory at time listed in this column to be included in the same day testing, if samples arrive later than time listed here it will be tested in the next available run
STAT and Critical Specimens Testing
Priority testing is available outside of regular hours stated in “Frequency and turnaround time” section upon approval from PHO microbiologist. Contact PHO’s laboratory Customer Service at 416-235-6556/1-877-604-4567 or after-hours, contact the Duty Officer at 416-605-3113 for consultation.
Measles diagnosis is performed using polymerase chain reaction (PCR) – Laboratory developed test validated at PHO’s laboratory; not Health Canada approved.
Measles Vaccine Genotype is performed using polymerase chain reaction (PCR) – Laboratory developed test validated at PHO’s laboratory; not Health Canada approved.
Content/Test Algorithm
Positive measles PCR will be tested first in-house with measles vaccine genotype PCR, all negative in-house measles vaccine genotype PCR will be referred to NML for full genotyping
Refer to NML for more information on measles genotyping - https://cnphi.canada.ca/gts/reference-diagnostic-test/4996?labId=1016.
Content/Test Interpretation
Results will be reported as DETECTED/NOT DETECTED/INDETERMINATE for measles virus PCR.
- Indeterminate results - An indeterminate PCR test result may be due to a low level of target genetic material in the specimen, inadequate specimen content, or a non-specific signal. Please submit another specimen for testing if clinically indicated.
- This result must be interpreted within the context of the clinical history and epidemiological information.
- A negative result does NOT exclude the possible presence of measles virus.
Results will be reported as DETECTED/NOT DETECTED for measles vaccine genotype PCR.
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